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Heller myotomy

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https://www.readbyqxmd.com/read/28496526/changing-trends-in-age-gender-racial-distribution-and-inpatient-burden-of-achalasia
#1
Vaibhav Wadhwa, Prashanthi N Thota, Malav P Parikh, Rocio Lopez, Madhusudhan R Sanaka
BACKGROUND: Achalasia is an idiopathic esophageal motility disorder characterized by dysphagia, regurgitation, chest discomfort and weight loss. The aim of this study was to evaluate the temporal trends in demographic variables, interventions, and inpatient burden in achalasia-related hospitalizations. METHODS: We evaluated the National Inpatient Sample Database (NIS) for all patients in whom achalasia (ICD-9 code: 530.0) was the principal discharge diagnosis from 1997 to 2013...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28475741/clinical-presentation-and-disease-course-of-patients-with-esophagogastric-junction-outflow-obstruction
#2
K L Lynch, Y-X Yang, D C Metz, G W Falk
Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation pressure, can result from specific anatomic variants or may represent achalasia in evolution. There is limited information on the clinical significance of this diagnosis. The aim of this study is to describe the clinical characteristics and outcomes in our cohort of patients with esophagogastric junction outflow obstruction.Consecutive adult patients who had undergone high-resolution esophageal manometry between February 2013 and November 2015 with a diagnosis of esophagogastric junction outflow obstruction were identified...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28472017/systematic-review-and-meta-analysis-of-perioperative-outcomes-of-peroral-endoscopic-myotomy-poem-and-laparoscopic-heller-myotomy-lhm-for-achalasia
#3
Aiman Awaiz, Rossita M Yunus, Shahjahan Khan, Breda Memon, Muhammed A Memon
AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed...
May 3, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28460739/twenty-year-trends-in-the-utilization-of-heller-myotomy-for-achalasia-in-the-united-states
#4
Kelly R Haisley, Jennifer F Preston, James P Dolan, Brian S Diggs, John G Hunter
INTRODUCTION: Trends in the utilization of Heller myotomy for achalasia in the U.S. over time have not been previously described. MATERIALS AND METHODS: Using the Nationwide Inpatient Sample (NIS) database, we analyzed patients undergoing Heller myotomy for achalasia over a 20-year period (1992-2011) to estimate rates of Heller myotomy, locations where the procedures were performed (rural, urban or teaching) and changes in technique (laparoscopic vs open) as well as outcomes of length of stay and in-hospital mortality...
March 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28451814/the-relationship-between-manometric-subtype-and-outcomes-of-surgical-treatment-for-patients-with-achalasia-achalasia-manometric-subtypes
#5
Oscar Maximiliano Crespin, Roger Perry Tatum, Keliang Xiao, Ana Valeria Martin, Saurabh Khandelwal, Carlos Alberto Pellegrini, Brant Kurt Oelschlager
BACKGROUND: The Chicago Classification describes three distinct subtypes of achalasia and it appears to be a promising tool in predicting results of treatment with standard Heller Myotomy. The aim of this study is to analyze the outcomes of surgical treatment for achalasia using an extended Heller myotomy for each subtype and to identify additional parameters that may predict the success of therapy. METHODS: 72 consecutive patients with achalasia were evaluated at the University of Washington between 2008 and 2013...
April 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#6
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
April 19, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28416923/esophageal-achalasia-predictive-value-of-preoperative-resting-pressure-of-les-correlated-with-type-of-fundoplication
#7
Antonio Tancredi, Antonello Cuttitta, Roberto Scaramuzzi, Gerardo Scaramuzzi, Marco Taurchini
OBJECTIVE: The aim of the present study is to show the predictive value of the preoperative resting pressure of the lower esophageal sphincter (LES) correlated with the type of fundoplication (Nissen or Dor) after Heller myotomy in our series. MATERIALS AND METHODS: From January 1998 to June 2010, 88 patients affected by esophageal achalasia underwent surgery at our unit. However, our study focused on a sample of 36 patients, because many data were lost or was never recorded...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28396032/dissatisfaction-after-laparoscopic-heller-myotomy-the-truth-is-easy-to-swallow
#8
Alexander Rosemurgy, Darrell Downs, Gianvanna Jadick, Forat Swaid, Kenneth Luberice, Carrie Ryan, Sharona Ross
BACKGROUND: Although laparoscopic Heller myotomy has been shown to well palliate symptoms of achalasia, we have observed a small subset of patients who are "Dissatisfied". This study was undertaken to identify the causes of their dissatisfaction. STUDY DESIGN: Patients undergoing laparoscopic Heller myotomy from 1992 to 2015 were prospectively followed. Using a Likert scale, patients rated their symptom frequency/severity before and after the procedure. Patients graded their experience from "Very Satisfying" to "Very Unsatisfying...
April 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28375487/the-role-of-heller-myotomy-and-poem-for-nonachalasia-motility-disorders
#9
F Schlottmann, N J Shaheen, R D Madanick, M G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders such as Diffuse Esophageal Spasm (DES), Nutcracker Esophagus (NE) and the Hypertensive Lower Esophageal Sphincter (HTN-LES). Most patients with DES and HTN-LES who complain of dysphagia improve after a myotomy. Patients with NE whose main complaint is chest pain, often do not have relief of the pain and can even develop dysphagia as a consequence of the myotomy...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375480/same-day-discharge-in-benign-esophageal-surgery-a-prospective-cohort-study
#10
A Desbeaux, C Gronnier, G Piessen, M Vanderbeken, N Ruolt, J-P Triboulet, C Mariette
Day-case esophageal surgery has been demonstrated to be safe in small prospective cohorts and only for laparoscopic fundoplication. The aims of this study are to assess the feasibility and safety of a large series of esophageal day-case surgeries, including laparoscopic Nissen fundoplication (LNF), Zenker diverticulectomy (ZD), and laparoscopic Heller myotomy (LHM) and to compare the outcomes among three procedures.This was a prospective, observational study of selected patients who underwent day-case LNF, ZD, and LHM between 2003 and 2013...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#11
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28361836/the-choice-of-myotomy-in-achalasia-cardia-heller-s-or-per-oral-endoscopic-myotomy
#12
EDITORIAL
Zaheer Nabi, Mohan Ramchandani, D Nageshwar Reddy
No abstract text is available yet for this article.
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28260955/peroral-endoscopic-myotomy-procedural-complications-and-pain-management-for-the-perioperative-clinician
#13
Lopa Misra, Norio Fukami, Katarina Nikolic, Terrence L Trentman
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28145968/outcome-of-peroral-endoscopic-myotomy-poem-for-treating-achalasia-compared-with-laparoscopic-heller-myotomy-lhm
#15
Lijun Peng, Shuni Tian, Chao Du, Ziying Yuan, Mingxiao Guo, Lin Lu
OBJECTIVE: Peroral endoscopic myotomy (POEM) is an emerging endoscopic treatment for achalasia and the long-term efficacy of POEM remains to be evaluated. This study compared the outcomes of POEM with that of the standard laparoscopic Heller myotomy (LHM) for achalasia. MATERIALS AND METHODS: Achalasia patients treated by POEM or LHM were retrospectively analyzed, with a minimum postoperative follow-up of 3 years. Perioperative outcomes and long-term outcomes including treatment success (Eckardt score ≤3), occurrence of gastroesophageal reflux disease (GERD) (GerdQ score ≥9) and quality of life (36-item short form) were compared...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#16
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
March 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28118216/retropharyngeal-perforation-with-an-esophageal-dilator-a-case-report
#17
Gregory J Blair, Robert Hsiung
Esophageal "bougie" dilators are frequently used during esophageal surgeries to facilitate reconstruction and manipulation of the esophagus. Insertion of such dilators is usually a blind technique and not without risk. We present a case of retropharyngeal wall perforation resulting from esophageal dilator misplacement in a patient undergoing laparoscopic Heller myotomy and reconstruction. This case report demonstrates the importance of communication between surgery and anesthesiology teams during placement of devices into the oropharynx...
April 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28099056/multidisciplinary-approach-to-esophageal-achalasia-a-single-center-experience
#18
Francisco Schlottmann, Ciro Andolfi, Robert T Kavitt, Vani J A Konda, Marco G Patti
BACKGROUND: The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. MATERIALS AND METHODS: A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed...
April 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28052278/diagnosis-and-treatment-strategy-of-achalasia-subtypes-and-esophagogastric-junction-outflow-obstruction-based-on-high-resolution-manometry
#19
REVIEW
Eikichi Ihara, Kazumasa Muta, Keita Fukaura, Kazuhiko Nakamura
BACKGROUND: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes...
2017: Digestion
https://www.readbyqxmd.com/read/28039638/effects-of-laparoscopic-myotomy-on-the-esophageal-motility-pattern-of-esophageal-achalasia-as-measured-by-high-resolution-manometry
#20
Renato Salvador, Edoardo Savarino, Elisa Pesenti, Lorenzo Spadotto, Guerrino Voltarel, Giovanni Capovilla, Francesco Cavallin, Loredana Nicoletti, Michele Valmasoni, Alberto Ruol, Stefano Merigliano, Mario Costantini
BACKGROUND: Esophageal achalasia can be classified on the grounds of three distinct manometric patterns that correlate well with final outcome after laparoscopic Heller-Dor myotomy (LHM). No analytical data are available, however, on the postoperative picture and its possible correlation with final outcome. The aims of this study were: (a) to investigate whether manometric patterns change after LHM for achalasia; (b) to ascertain whether postoperative patterns and/or changes can predict final outcome; and (c) to test the hypothesis that the three known patterns represent different stages in the evolution of the disease...
December 30, 2016: Surgical Endoscopy
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